Individual provider Active NPI

Peter Ronald Pretkel, PSY.D.

  • Clinical Psychologist
  • Napa, CA
National Provider Identifier
1093836603
Registry record updated Apr 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 23168 Issued in CA
Practice address
2100 Napa Vallejo Hwy
Napa, CA 94558-6234
Phone
(707) 253-5000
Fax
(707) 253-5097
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 23168 CA Primary

Addresses

Primary practice location

2100 Napa Vallejo Hwy
Napa, CA 94558-6234

Mailing address

2100 Napa Vallejo Hwy
Napa, CA 94558-6234
Phone (707) 253-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100323000388 CA Practitioner - Clinical Psychologist 1658406129 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY 23168CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Sep 30, 2014 Accepting new patients
Sud Specialty Group - Ca CurrentSince May 1, 2025 Accepting new patients
Department of State Hospitals CurrentSince Sep 30, 2014 Accepting new patients

Locations

10333 El Camino Real
Atascadero, CA 93422
Phone (805) 468-2000

2100 Napa Vallejo Hwy
Napa, CA 94558
Phone (707) 253-5000

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398556800000",
    "number": "1093836603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NAPA VALLEJO HWY",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586234",
            "telephone_number": "707-253-5000",
            "fax_number": "707-253-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 NAPA VALLEJO HWY",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945586234",
            "telephone_number": "707-253-5000",
            "fax_number": "707-253-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRETKEL",
        "first_name": "PETER",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2014-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 23168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

Verify at the official NPI Registry.